Anesthesiolgists and Addiction

This anesthesioloist fucked up, so CLEARLY he was NOT more than capable of doing his job under the influence. Big difference between a functioning user and a complete idiot which the doctor in the article proved to be. Two lives were lost due to his negligence and that's awful.

How do you know it wasn't just a mistake that would of happened if he was sober? He WAS a functioning addict. He obviously did his job fine for years before the tragedy that occured but to blame him for negligence as a result of being under the influence is ludicrous.

I'm sorry for your loss but you are in no place to judge anybody who uses drugs in the work place because your opinion is biased.

People like you are awful. Demonizing functioning addicts. If this doctor wasn't a function addict he would of fucked up way earlier bro.

Considering you don't like people under the influence, you should hate every doctor and worker out there. Caffeine is a drug used by doctors and other workers every day bro.
 
There are functioning users, "addicts", whatever. I take my daily dose of 60mg oxy and can drive and do my studies and job just fine.

That's what the doctor was. He took his dose of whatever daily. He was able to do his job fine.

If you get in an accident one day and hurt someone, is your addiction to blame? Would you be an idiot like you called that doctor?
 
That's what the doctor was. He took his dose of whatever daily. He was able to do his job fine.

If you get in an accident one day and hurt someone, is your addiction to blame? Would you be an idiot like you called that doctor?

There's no evidence of that. If the doctor is stealing meds from patients, trying to surreptitiously dose while he's supposed to be working, going into withdrawals during procedures etc. then of course it's going to affect his work. That's the real issue here. If he was taking consistent doses from a regular source and not going under (withdrawal) or over (nodding) his maintenance dose at work, then it probably wouldn't affect his work, but that's not the situation.

Interestingly, the circumstances of one of the doctors from the original article sounded very familiar, turns out he went on to become a big proponent for suboxone, which he now prescribes, and maintains a blog on the issue of suboxone, opioid maintenance, opiate addiction in general and pain managament. Very interesting reading for the opiate geeks out there: http://suboxonetalkzone.com/
 
That's what the doctor was. He took his dose of whatever daily. He was able to do his job fine.

If you get in an accident one day and hurt someone, is your addiction to blame? Would you be an idiot like you called that doctor?

Stealing from patients is doing his job fine?

Edit: If I got into an accident While I was driving "high" then damn right I'm to blame. I can take responsibility for u actions. Itd be my own stupid fault for hurting someone because I was too high. It's along the same lines as drunk driving.
 
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How do you know it wasn't just a mistake that would of happened if he was sober? He WAS a functioning addict. He obviously did his job fine for years before the tragedy that occured but to blame him for negligence as a result of being under the influence is ludicrous.

I'm sorry for your loss but you are in no place to judge anybody who uses drugs in the work place because your opinion is biased.

People like you are awful. Demonizing functioning addicts. If this doctor wasn't a function addict he would of fucked up way earlier bro.

Considering you don't like people under the influence, you should hate every doctor and worker out there. Caffeine is a drug used by doctors and other workers every day bro.

First off, stop calling me bro. I'm a female.

Secondly, never once did I say I hate functioning drug addicts. I hate when the "functioning" addict has to steal from his/her patients and ends up causing fatalities.

Third, I'm far from an "awful person demonizing functional addicts".
 
Hey y'all, let's tone this down a bit, shall we?
No need to turn this into a personal attack-type of situation.

The issues that we are discussing are very interesting, and worthy of discussion.

But if we cannot do so with kindness and compassion, it is better to just drop it.

(If you can't say things nicely...)

Let me make a list of some of the most interesting issues raised so far, to my mind. Others, feel free to add to the list.

a) whether functioning drug addicts should be responsible when they make mistakes in some way that non-drug-users are not
b) whether it is possible to be a successful functioning drug addict
c) if/ to what extent drug use may be the cause when a person on drugs makes a mistake
d) whether/to what extent the doctor in the article (or his drug use) was responsible for his mistakes
e) whether the type and dose (and ROA, etc.) of drug affects our responses to (a-d).


As for (a): are there any non-drug-users in the world? It really depends on your definition, but it seems pretty easy to argue that there are not.

As for (b): I would argue that it is clearly possible.

As for (e): Notice that one person has said that she wouldn't want a surgeon on caffeine, but would be fine if her surgeon were on sugar. Others might say that caffeine is fine, but speed is not. But these drugs really exist on a continuum, and a huge dose of caffeine is far more dangerous than a tiny dose of speed.


These are all subtle issues, and we deeply appreciate people arguing passionately for one side or the other. But without name-calling, or personal attacks, please!
 
I was never interested in going into anesthesiology, but I know a number of classmates from medical school who were. From what they said, the stigma in the profession surrounding recreational drug use borders on the extreme. The vetting process for a typical anesthesiology residency is designed to weed out anyone who's even considered bending their minds chemically. It's a job for the perpetually sober, for people whose world has no place for recreational drugs, never did and never will. It's a very similar job to being an airline pilot, in this way.

Aw, come on! Pilots all hit the bar every time they land in a new city, don't they?

Right now, all you guys' debating about whether an opiate-positive anesthesiologist is intoxicated or maintaining is all very academic. This kind of debate is anything but academic when it's happening in court, after someone couldn't be revived. When the shit hits the fan, nobody is going to have much sympathy for that anesthesiologist's arguments that his positive urine test for opiates meant that he was more functional than he's otherwise have been, and that that test result couldn't have been the cause for his inability to keep the plaintiff's family member alive. Try and see this from the patient's perspective, and from a general medico-legal risk management perspective. If the anesthesiologist never uses opiates at all to begin with, then and only then can drug use be entirely eliminated as a potential factor in any mistakes he makes.

Is the guy who hails a taxi and smells alcohol on the cabby's breath really ready to buy a story about how the cabby drives better with a few drinks in him, and that he's lucky his driver isn't about to go into delirium tremens? Of course not -- he's ready to find another cab!

Very good points. Most people won't give a shit about any argument that the anesthesiologist was functioning better than if he were in withdrawal... and they shouldn't, as going into withdrawal would have been the result of choices that the anesthesiologist made that affected his ability to do his job.
 
Aw, come on! Pilots all hit the bar every time they land in a new city, don't they?

Not if they're going to fly again within 48h. Again, this is more for other people's peace of mind more than for the pilot's personal good, or really any practical considerations. Yes, we all know that a typical pilot could fly just fine one day after having one beer. But if shit goes awry and many people's lives are at stake, the airline company's continued ability to stay in business depends on there not even being the slightest question that the pilot was utterly substance free.

Anyone who has any gripes about drug intolerance at their (or any) place of work really ought to read the Wikipedia entry on Risk Management. Bottom line: if an institution asks people to surrender their personal safety to this institution's mercy, the institution owes it to the public (from whence their clientele comes) to lay to rest any possible suspicion that its workers take unnecessary risks with clients' personal safety. Otherwise the institution loses public trust, loses clientele, and is forced to fold.

I think people need to face the fact that when you're being paid by someone to do a job, the unwritten agreement is that your employer's best interests come before your own, period the end. The employer will, therefore, ban employees from doing anything that put its best interests in jeopardy. I'm sorry if this sounds cold, corporate, or anti-individualist. I don't mean to give the impression The Man has gotten me down, or I've drank the corporate Kool Aid. I only mean to explain why a policy that seems (and indeed is) unfair to the individual worker actually makes a lot of sense for the person holding the purse strings, and is not likely to change.

Very good points. Most people won't give a shit about any argument that the anesthesiologist was functioning better than if he were in withdrawal... and they shouldn't, as going into withdrawal would have been the result of choices that the anesthesiologist made that affected his ability to do his job.

Right. Most employers who hire anesthesiologists (or pilots) would rather skip this hairy debate altogether, and simply hire only people for whom the entire debate would be moot.

The fact is, an anesthesiologist who has ever used recreational drugs is a higher risk than one who has not, and statistics prove this.

Interestingly, an anesthesiologist who loses a patient on the operating table is probably out a career, period. Why? Because the market is saturated with anesthesiologists who have never lost anyone. Why would any patient or hospital take the risk on one who'd made a big mistake, when they'll have so much more peace of mind with one of the many who've made no mistakes?

I speak as a medical doctor who is not entirely substance free. I do not work in any state but sober, and plan my use of substances carefully so as to avoid any clouding of my judgement or risk to patients or my employer. I keep my mouth shut -- I have never even posted my real name, my photo, or my exact location here on BL. I think laws surrounding recreational drug use are unjust, and drug testing results correlate poorly with states of intoxication. But until those two things change, I do not begrudge my employer or my licensing board for looking out for their own asses, when it comes to me.
 
the article said:
Dr. Gold decided to take a close look at O.R. procedures and was immediately struck by the anesthesiologists' posture. They weren't standing upright or moving around, like everyone else involved in the operation, but spent the entire time crouched right next to the patient's head. Dr. Gold watched a heart operation and noticed that during the 10-hour procedure, the anesthesiologist never budged from his post, not even for a bathroom break.

Wait, he thought. What if the drugs are escaping from the patients' breath? The system for delivering drugs may be airtight, but how about the ventilation? Dr. Gold enlisted the University of Florida's nanotechnology group to use its mass spectronomy equipment to test for the presence of drugs above a patient's mouth. They scanned an O.R., and . . . jackpot! Sure enough, narcotics were detected not only in the air, but also on metal trays and tables -- exactly the way vaporized gas would settle. "Fentanyl is extremely potent and active in the air -- that's why the Russians used it to put everyone in the theater to sleep during the Chechen hostage crisis," Dr. Gold explains. "It's also easily absorbed through the skin."

This would explain why the best, most requested anesthesiologists are the most prone to addiction: They handle more cases and more of the long, multihour procedures, so they're more exposed to airborne drugs. It also explains why addicts tend to be in their early 30s and suffer such rampant recidivism: Fresh out of medical school and internships, they're inhaling narcotics for the first time, and when they return to work after rehab, they're unwittingly using again.

After reporting his findings at the annual conference of the Association for Medical Education and Research in Substance Abuse, Dr. Gold is now collecting blood samples from nonaddicted anesthesiologists to test for trace levels of narcotics.

As for why every anesthesiologist isn't hooked, you have to figure in genetic predisposition, says Paul Earley, M.D., medical director of the Impaired Professionals Program at the Ridgeview Institute, in Atlanta. Addicts are five to seven times more likely to have a sibling or parent who is chemically dependent. This inherited vulnerability would explain why some, but not all, anesthesiologists react to the narcotized air; the fumes may affect only those pre-equipped with a genetic flip switch.

Excuse me Dr. Gold, but while this may have merit for recidivism, it does nothing to explain why Anesthesiologists are more likely to be users. If they didn't KNOW that they were ingesting opiates, and have no history of prior use how the hell will this lead them to begin usage themselves? The fact that they're squatting uncomfortably for hours seems a more likely explanation for their starting opiate use.
 
I met an anesthesiologist last time i was in treatment hooked to opiods. He had many years clean, got prescribed tramadol, then during his next surgery he relapsed on demerol. He ended up OD'ing and the patient regained somewhat consciousness during his surgery. Also i agree with judge people on performance, not their habits.
 
^You are assuming there is no correlation between the two. An opiate addict doc on sub/methadone maintainence would be one thing, an addicted doc dosing unreliably/illicitly is something else (especially one stealing medication from a patient, which is absolutely monstrous!).

I do not condone for the doc to steal the medication from the patient. What I was trying to say is if said doctor likes to bang a gram of dope on weekends when he's not working thats his business. As long as his habits/activity does not affect his job (stealing meds from a patient affects his job, no? Nodding out would affect the job, no?) he/she should not be scrutinized. People drink on the weekends and come into work the next day, whats the difference of using a different drug of choice? I don't bitch at people for drinking vodka when I'm a tequila guy, so why should I be discriminated against for liking a good fat shot of heroin (which is healthier, read: less damaging, for the body when product is clean and IV technique is proper) than a fifth of godawful toxic (any amount of alcohol causes damage to the body) alcohol (which is a "legal" addiction). An addict is an addict, so if s/he is not being unethical or his performance is not failing then this person should keep their job.
 
^ the likelihood that someone could use IV heroin in a manner comparable to someone having a couple drinks during a football game with friends is a bit absurd; not impossible but wildly unlikely.

Few drug users even go to the needle before they are physically dependent and regardless, I would be concerned about any excessive substance abuse from a doctor even when they are off-duty... in your example you mentioned drinking a whole 5th and even if someone just does this when they are not working, that degree of abuse will have physical and psychological repercussions that will undoubtedly spill over into their professional performance. The same can be said for opioid abuse when taken to the extreme such as 'banging a gram of dope on weekends'.

Practically speaking you are probably not going to find physicians who are safely and responsibly shooting up heroin on their days off and their substance use not impacting their work at all.

Any substance use that surpasses normal, social use poses a threat to a physicians performance when mental acuity and physical precision are absolutely essential and tiny mistakes can equate to paralysis or death. I would not consider drinking entire bottles of liquor or shooting up grams of heroin normal, social use.
 
^ the likelihood that someone could use IV heroin in a manner comparable to someone having a couple drinks during a football game with friends is a bit absurd; not impossible but wildly unlikely.

Few drug users even go to the needle before they are physically dependent and regardless, I would be concerned about any excessive substance abuse from a doctor even when they are off-duty... in your example you mentioned drinking a whole 5th and even if someone just does this when they are not working, that degree of abuse will have physical and psychological repercussions that will undoubtedly spill over into their professional performance. The same can be said for opioid abuse when taken to the extreme such as 'banging a gram of dope on weekends'.

Practically speaking you are probably not going to find physicians who are safely and responsibly shooting up heroin on their days off and their substance use not impacting their work at all.

Any substance use that surpasses normal, social use poses a threat to a physicians performance when mental acuity and physical precision are absolutely essential and tiny mistakes can equate to paralysis or death. I would not consider drinking entire bottles of liquor or shooting up grams of heroin normal, social use.

But the reality is that doctors aren't saints and they do use drugs, and I'd prefer the opiate addicted doctor over the alcoholic one any day of the week, if it weren't for the fact that prohibition causes them to steal meds from their own patients.
 
It's quite disingenuous to say that 'prohibition' caused them to make the choice to steal medication from their patients. Addicts in every corner of the globe find ways to get their drugs of choice without stealing from patients and doctors likely have far more means and resources than most all junkies to acquire whatever they desire.

I don't expect anyone to be 'saints' and I am perfectly fine with social and light recreational substance use but that is world's away from drinking fifth's of vodka or banging grams of heroin which is unprofessional and unacceptable from someone whose hands you entrust to life in. Physicians have ethical responsibilities and just like how it is unethical for them to operate on family members because they couldn't be objective, it's not right for them to engage in behaviors that could adversely affect their judgment which substance abuse (beyond light, social use) undoubtedly could.

You can argue the relative detriment of individual substances all day but my point is that *beyond* light, social use the doctor is taking risks that are untenable for their profession.
 
First off, stop calling me bro. I'm a female.

Secondly, never once did I say I hate functioning drug addicts. I hate when the "functioning" addict has to steal from his/her patients and ends up causing fatalities.

Third, I'm far from an "awful person demonizing functional addicts".

Are you a user? Add a bit of heavy abuse and you might just be defending the opinions you're currently against the next time a thread like this rolls around.

The reason I find opiates so dangerous is because people can function perfectly while under the influence. It makes it really hard to realize the changes it's making in your way of thinking. You start to prioritize your medicine, and start to lose track of where the lines you must not cross lay in the sand, and eventually you find yourself on BL one day posting in a thread like this completely ignorant of how insane the shit you just typed actually sounds to people who are fully sober from time to time.

I think hope we can all agree it's not normal in any capacity to live a life where your only two options are to a) go sick or b) dose 8o
 
It's quite disingenuous to say that 'prohibition' caused them to make the choice to steal medication from their patients. Addicts in every corner of the globe find ways to get their drugs of choice without stealing from patients and doctors likely have far more means and resources than most all junkies to acquire whatever they desire.
because of prohibition, there are dry periods. during a dry period when the dealer has no product, a doctor has three choices. A) take sick days (may be impossible, this is america not sweden)... B) perform surgery or anesthesia with a hand shaking out of control and almost no cognitive capacity... C) find the nearest possible dose, and relieve the sickness, and do the surgery.

if it weren't for prohibition, the doctor could have D) gone to a pharmacy and purchased a box of dilaudids, and never would have gotten sick or shaky in the first place.
 
My point was that he CHOOSES that, you just explained that he has choices, exactly what I was saying. He isn't forced by prohibition to steal a patient's medication. Prohibition narrows his choices, not steals his free will.

If someone gets to a point where they are that bad off, I do not think they should be practicing medicine. If someone had another physical or mental medical condition that affected their judgment, cognitive ability, physical dexterity, etc, as much as addiction can when their dealers are 'dry', they would not be allowed to practice.
 
Are you a user? Add a bit of heavy abuse and you might just be defending the opinions you're currently against the next time a thread like this rolls around.

The reason I find opiates so dangerous is because people can function perfectly while under the influence. It makes it really hard to realize the changes it's making in your way of thinking. You start to prioritize your medicine, and start to lose track of where the lines you must not cross lay in the sand, and eventually you find yourself on BL one day posting in a thread like this completely ignorant of how insane the shit you just typed actually sounds to people who are fully sober from time to time.

I think hope we can all agree it's not normal in any capacity to live a life where your only two options are to a) go sick or b) dose 8o

I use around 60-80mg oxy on a daily basis and have for about over a year. Occasionally I use H. So screw you for thinking I don't know how horrible addiction is.

Find my opinions "insane" or whatever the fuck you wish. I personally don't care. I didn't post the article to troll, I posted it because I found it interesting and some aspects disturbing.
 
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